MEDICARE: KEELY B GODWIN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	200200328	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	132RU	OTHER		BCBS NC
3	132RU	OTHER	NC	BCBS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	7154477	OTHER		AETNA

General Provider Information

NPI Number	:	1013940964
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEELY B GODWIN MD

Provider Business Mailing Address
First Line	:	1031 W WILLIAMS ST
Second Line	:	SUITE106
City	:	APEX
State	:	NC
Zip	:	27502-3955
Country	:	US
Telephone Number	:	919-363-0190
Fax Number	:	919-363-0195

Provider Business Practice Location Address
First Line	:	1031 W WILLIAMS ST
Second Line	:	SUITE106
City	:	APEX
State	:	NC
Zip	:	27502-3955
Country	:	US
Telephone Number	:	919-363-0190
Fax Number	:	919-363-0195

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2006
Last Update Date	:	03/27/2013

Similar Medicare Providers

1568321909 — SHERRIE L BASS
Practice Location Address:

1031 W WILLIAMS ST STE 102
APEX, NC
27502-3955

Practice Phone: 919-439-9693
Practice Fax:

1376540112 — DR. BRIAN RAY FORREST M.D.
Practice Location Address:

1031 W WILLIAMS ST , SUITE 106
APEX, NC
27502-3955

Practice Phone: 919-363-0190
Practice Fax: 919-363-0195

1326020611 — WAKE HEART AND VASCULAR ASSOCIATES P.A.
Practice Location Address:

1031 W WILLIAMS ST , 105-B
APEX, NC
27502-3955

Practice Phone: 919-387-4120
Practice Fax: 919-387-4148

1467413419 — DR. MILTON WALDO RICHARDSON DPM
Practice Location Address:

1031 W WILLIAMS ST , #105
APEX, NC
27502-3955

Practice Phone: 919-363-3310
Practice Fax: 919-363-3370

1912969155 — MR. GREGORY BASHOR MPT
Practice Location Address:

1031 W WILLIAMS ST , SUITE 103
APEX, NC
27502-3955

Practice Phone: 919-249-4040
Practice Fax: 919-249-4043

1780612515 — DR. MICHAEL E BASS DDS
Practice Location Address:

1031 W WILLIAMS ST , SUITE 101
APEX, NC
27502-3955

Practice Phone: 919-362-6789
Practice Fax:

Directions to “ KEELY B GODWIN MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.